Journal of Multidisciplinary Healthcare (Jul 2024)

Bone Disease among Children with Sickle Cell Disease: A Scoping Review of Incidence and Interventions

  • Mulyana AM,
  • Rakhmawati W,
  • Pramukti I,
  • Lukman M,
  • Wartakusumah R,
  • Mediani HS

Journal volume & issue
Vol. Volume 17
pp. 3235 – 3246

Abstract

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Aep Maulid Mulyana,1,* Windy Rakhmawati,2,* Iqbal Pramukti,3,* Mamat Lukman,3,* Riki Wartakusumah,4,* Henny Suzana Mediani2,* 1Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 2Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 3Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 4Department of Nursing Science, Faculty of Medicine Public Health, and Nursing, Universitas Gadjah Mada, Sleman, Yogyakarta, 55284, Indonesia*These authors contributed equally to this workCorrespondence: Henny Suzana Mediani, Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia, Tel +62 822-1739-1965, Email [email protected]: Children with sickle cell disease (SCD) are more likely to have deficient serum levels of vitamin D for bone metabolism. However, appropriate interventions are essential to prevent its progression and alleviate symptoms.Purpose: The aim of this study is to determine interventions for managing bone disease in children with SCD.Methods: This study uses a scoping review. A literature review was conducted using PubMed, CINAHL, ScienceDirect, Scopus, and Google Scholar search engines. The study was eligible for inclusion if it included articles published from 2013 to 2023, full-text, and original study design. Study quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool.Results: This review identified six studies and 114 children with SCD, including 57 boys (50%) and 57 girls (50%). The majority of SCD types experienced were HbSS (86.84%), HbS-B0 Thal (7.01%), HbSC (5.27%), and the HbSS Arab-Indian haplotype (0.88%). Bone disease problems that often arise in children with SCD include Avascular Necrosis (AVN) (78.08%), Osteonecrosis of the Femoral Head (ONFH) (18.42%), and other bone problems (3.50%). Meanwhile, four types of intervention findings were used in managing bone disease among children with SCD: 1). Surgical procedures 53 (41.09%) included total hip arthroplasty (THA), Osteotomy, and Multiple epiphyseal drilling with Autologous Bone Marrow Implantation (AMBI); 2). Invasive procedures 67 (51.93%) included intravenous bisphosphonates, hydroxyurea (HU), and core decompression (CD) with bone marrow aspirate concentrate injection: 3). Oral pharmacological or Vitamin D3 (cholecalciferol) 4 (3.10%); 4). Non-pharmacology or physical therapy 5 (3.88%).Conclusion: Our findings highlight that surgical, invasive, pharmacological, and physical therapy interventions positively impact increasing bone mineral density (BMD) and functional improvement of bone disease among children with SCD. The interventions provided excellent functional outcomes with minimal complications and no life-threatening side effects.Keywords: bone disease, children, intervention, incidence, sickle cell disease

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